Bereavement Symptoms Different than Depressive Symptoms in Older Adults

Bereavement and depression may have similar symptoms, but should remain clinically differentiated, according to researchers from KU Leuven in Belgium.

The death of a spouse can often trigger depression-like symptoms; however, these symptoms should not be diagnosed as depression, according to findings published in the Journal of Abnormal Psychology.

Researchers from KU Leuven in Belgium observed depressive symptoms in more than 500 patients who were both married and widowed in order to bring about a 2 pronged conclusion. First, the researchers wanted to examine the traditional triggers causing depression which can lead to symptoms. Secondly, the researchers wanted to explore a novel explanation to why bereavement directly contributes to depressive symptoms. The researchers examined data from the Changing Lives of Older Couples (CLOC) study and compared depressive symptoms among participants aged 65 years or older who had lost their partner to those who were still married.

The participants who had lost spouses during the observation period were brought in for a follow up interview 6 months after loss. The researchers similarly interviewed the still married couples after 6 months. The researchers determined that spousal loss causes a number of specific depressive symptoms, specifically loneliness. Additionally, the investigators concluded that few initial depressive symptoms actually trigger a specific network of following depressive symptoms. The authors were also quick to point out that adverse live events can lead to depressive symptoms that are not always clinical depression.

“This has implications for prevention and intervention in elderly bereaved people,” explained study leader Eiko Fried. “Instead of targeting depression in general, specifically targeting key symptoms such as loneliness may prevent the activation of further symptoms in a person's psychopathological network and prevent the development of a full-fledged depression.”

A growing concern for the research team about depression is the clinical definition published in the latest edition of the DMS-5, from 2013. The manual removed the distinction between depression and bereavement, which can cause diagnosing problems down the road.

“This has been a topic of huge debate, and we fear that in many people who exhibit a normal grief response after losing their partner, normal sadness may be misdiagnosed as pathological depression,” added Fried.

The authors added that this was the first study of its kind, which evaluated the “network approach” in order to identify differences and associations between loss of a spouse and depressive symptoms.

“The direct effects of spousal loss on particular symptoms are inconsistent with the predictions of latent variable models, but can be explained from a network perspective,” the authors concluded. “The findings support a growing body of literature showing that specific adverse life events differentially affect depressive symptomatology, and suggest that future studies should examine interventions that directly target such symptoms.”